TIPTON - A year after their son's fatal injury in a high school football playoff game, Ken and Amy Stover seek assurance from the Missouri State High School Activities Association that others playing football will be protected to the best extent possible.
Ken and Amy's son, Chad, died at University Hospital in Columbia two weeks after sustaining massive brain injuries while playing in the Tipton versus Sacred Heart playoff game in Sedalia on Oct. 31, 2013. Chad had turned 17 in the hospital, just shy of a week before he died.
"It's something you deal with every day," Ken said.
Ken and Amy discussed what happened to their son and the changes they would like to see implemented on Oct. 10 - senior night in Tipton. The Tipton Cardinals, Chad's team, were playing the Sacred Heart Gremlins again.
Instead of Ken and Amy walking Chad onto the field before the game with the other Tipton seniors and their families, Chad's red jersey was carried onto the field by his peers. Two cheerleaders carried the No. 18 jersey onto the field during the announcement of seniors, and later Chad's teammates brought it to the pre-game coin toss, where Sacred Heart players also paid their respects.
Instead of being in the stands getting ready to watch their son play one of his favorite sports, Ken and Amy sat under a shelter at City Park in Tipton. Yards away from where they sat was a memorial stone and tree commemorating their son at the baseball diamond where he also spent much time playing another game he loved.
"We've been invited, but it's just too hard," Amy said of senior night.
Ken and Amy still receive college recruitment materials addressed to Chad in the mail, reminders of what might have been.
Having an ambulance and certain equipment at the football field in Sedalia on the night of Chad's injury might have changed all of that, or it might not have.
"We don't know that it would have made a difference, but we don't have that luxury of knowing. We can't say everything was done to everybody's best ability to make sure that Chad was here today. We don't have that luxury," Amy said.
What Ken and Amy do know is that along with there not being an ambulance at the field in Sedalia, there wasn't any professional medical staff available that night, save for the nurse and ophthalmologist that happened to be in the stands and who tried to help Chad. Some pieces of medical equipment were also unavailable, specifically a piece of plastic for airway management.
"They were trying to use his rubber mouthpiece to get his mouth open to give him air," Ken said. "The tool they needed, my doctor showed me. It's a $10 piece of plastic, that could've made a huge difference in our kid's ... ," he said, before he trailed off into silence.
Ken and Amy want the Missouri State High School Activities Association to mandate that its member schools' emergency action plans require the presence of professional medical personnel carrying all needed equipment at all football playoff games.
"There needs to be a medical bag there with the basic equipment, and there needs to be somebody there that knows how to use it. And that's not just for the football players, it's for the cheerleader that falls off the pyramid, or the grandfather or mother or dad or sibling that falls down the bleachers, anything at all. But, where is it most likely to happen? Probably on the football field," Ken said.
"Those boys are out there representing their town, their community, their school. When you send your child off to any school function, I think you have full confidence they're going to be okay, they're at school, they're going to be taken care of. We know it's a dangerous sport, (but) do what you can do to take care of those boys that are out there," Amy said.
Statewide status of emergency action plans
MSHSAA currently recommends, but does not require, its member schools have emergency action plans, said Harvey Richards, associate executive director of MSHSAA.
However, Richards did point out that most schools in the state have already voluntarily created their own plans. MSHSAA provides templates for emergency action plans on its website, Richards said.
School districts are responsible for creating their own emergency action plans, he said.
For the 2014 edition of its annual, state law-mandated "Interscholastic Youth Sports Brain Injury Prevention Report," MSHSAA asked new questions of its member schools on emergency action plans and the use of ambulances, athletic trainers or other professional medical support.
Out of the 591 grade nine through 12 high schools and grade seven through 12 combined schools that MSHSAA sent the survey to, 578 completed MSHSAA's annual head injury survey, which included questions about the new emergency action plan and use of medical professionals.
Out of the 578 respondent high schools and combined schools, 518 said that their school district did have emergency action plans in place for all home contest sites, and 60 schools said that their district did not have such plans in place.
Responses on the use of medical professionals such as ambulances and athletic trainers varied.
One hundred ninety-five schools said that their district did not use the services of an athletic trainer or other medical support staff through the year, for practices or contests; 119 others said that such staff were used part-time, covering most, but not all varsity contests. One hundred fifty-five schools said that their district had ambulances at football games, but only varsity games.
MSHSAA does not require member schools to use any of the particular medical services surveyed on, out of recognition that some districts cannot afford to have athletic trainers or ambulances at every sporting event.
"Our school is very proactive. We always have an athletic trainer at all of our games, and we always have an ambulance at all of our games," Amy said of Tipton's emergency preparedness.
"If we have an ambulance at a game, and it gets called away, they stop the game and they wait for an ambulance to come in," she said.
"We've been watching that since before we had children old enough to be on the football field," Ken said.
The procedure without professionals
In the absence of professional medical staff like athletic trainers, "coaches and administrators must be expected to be called upon to assist injured athletes," MSHSAA stated in the "Emergency Action Planning" resource document available under the "Sports Medicine" section of its website.
Presently, head coaches are required to be certified in sports first aid, with specific topics taught dependent on the particular program, Richards said. Starting with the 2014-2015 school year, head coaches will be required to be re-certified in CPR/AED every two years; although not currently required, most head coaches already have CPR/AED certification, Richards said.
Airway management training in particular comes only with CPR/AED training, Richards said. However, even if someone knows airway management, only trained medical professionals such as EMTs and athletic trainers should use equipment like that which is used to keep someone's mouth open, Richards said. If the use of that equipment is needed and professional staff are not available, once 911 is called and an ambulance arrives, the EMTs will be able to use it, Richards said.
Rep. David Wood, R-Versailles, Tipton's state representative, said he was not aware of any current legislative proposals related to Chad's death. Wood did say that "the community suffered a great loss."
Ken and Amy agreed to be interviewed by TIME magazine, and Chad's story was the cover story of the Sept. 29 issue. They hoped that the publicity would keep the conversation about the issues surrounding Chad's death going, especially given a recent rash of deaths of high school football players playing the game.
Their hopes are with "the support that we have been given from all over the United States - letters, phone calls, people just coming up," Amy said.
"I remember one letter from a grandmother, "I have four grandsons playing the game. We hope and pray daily that your story moves people, and that our boys are protected.' I think it's a universal type of thing. We're not against football. We just want those boys that are out there playing, giving everything that they've got, protected," Amy said.